类风湿关节炎患者HLA-DR_4与Th_1/Th_2细胞因子的平衡关系

Relationship between HLA-DR_4 and TH_1/TH_2 cytokine balance in patients with rheumatoid arthritis

目的了解类风湿关节炎(RA)患者HLA-DR4与Th1/Th2细胞因子平衡之间的关系,探讨HLA-DR4在RA患者免疫应答中的作用。方法分别用聚合酶链反应-序列特性引物基因扩增法(PCR-SSP)对98例RA患者进行HLA-DR4基因型鉴定,用酶联免疫吸附实验(ELISA方法)测定IL-4、INF-γ。以INF-γ/IL-4反映Th1/Th2免疫应答的强度。结果INF-γ、IL-4、INF-γ/IL-42组间比较有显著性差异(P<0.01)。RA组中HLA-DR4阳性与阴性组INF-γ、IL-4、INF-γ/IL-4、ESR、CRP比较均有显著性差异(P<0.01)。结论RA患者存在Th细胞分泌细胞因子失衡,失衡模式为Th1型细胞因子占优势,而Th2型细胞因子相对低下,其HLA-DR4阳性与阴性组比值失衡程度有显著性差异,且与病情活动性及严重程度相关。

Objective It is to comprehend the relationship between HLA - DR4 and TH1/TH2 cytokine balance in patients with rheumatoid arthritis （RA）, and to discuss the action of HLA- DR4 in immunological response of patients with RA. Methods The method of DNA amplification with sequence-specific primers （PCR SSP） was used to determine HLA- DR4 allele. The serum levels of INF -γ and IL-4 were measured with enzyme linked immunosorbent assay. The strength of immunological response of TH1/TH2 was reflected by INF -γ/IL - 4. Results There were significant differences on INF -γ, IL- 4 and INF-γ/IL - 4 between the two groups （P 〈 0.01）. There were significant differences on INF-γ, IL- 4, INF-γ/IL- 4, ESR and CRP between HLA DR4 positive group and HLA DR4 negative group in RA group （P 〈 0.01）. Conelusion There is an imbalance of Th cytokine production in the patients with RA, which exhibited TH1 cytokine dominant and TH2 cytokine lower. There is significant difference on the ratio imbalance degree between HLA DR4 positive group and HLA- DR4 negative group in RA patients, and it is related to disease activity and serious degree.